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In the wake of the federal government's retrenchment from urban America in the 1970s and 1980s and the resulting rise in inequality, youth-serving, out-of-school time (OST) nonprofits took on a greater role in supporting urban public schools and students. Since then, many educational OST nonprofits have become enriching spaces for youth outside of traditional K–12 classrooms. Yet, their reliance on private philanthropic donations to function often complicates their goals. This article uses a critical, participatory, qualitative case study method to describe the experience of a youth-serving community-based education nonprofit organization in a Northeast city in the United States. In order to understand this nonprofit's role in the urban schooling community context, this article analyzes its aims and interrogates its barriers to success, using two theoretical perspectives: social reproduction and community cultural wealth. Qualitative analysis revealed that the organization is unmoored—unable to completely meet its own goals centered on community cultural wealth, because of limiting traditional conceptions of capital that reinforce and maintain unfair racialized power dynamics. [ABSTRACT FROM AUTHOR]

This study aimed to examine self-report of financial leverage, conflict, and satisfaction pertaining to representative payeeship for persons with mental illness, which research has not examined in the past decade. Sixty representative payee recipients with mental illness residing across the U.S. completed an online survey, with most (n = 50) receiving representative payeeship by family members/friends. Wilcoxon-Mann-Whitney tests and Spearman correlations were computed. One-third of participants reported experiencing financial leverage and conflict "sometimes" or more often and were dissatisfied with their representative payee arrangement. With the exception of use of alcohol and/or drugs, no participant characteristic was associated with financial leverage, conflict, or satisfaction. Financial leverage was reported to be greater when representative payees were family members/friends. Financial leverage and conflict were positively associated with each other and negatively associated with satisfaction. It is advisable that satisfaction with representative payeeship be increased and conflict resulting from representative payeeship be minimized. [ABSTRACT FROM AUTHOR]

The present study explored the role of perceived societal norms of multiculturalism in the engagement of cultural identity styles (hybridising‐HIS and altenating‐AIS) and, in turn, their impact on bicultural identity consolidation and cultural identity conflict. We examined 293 Chinese Americans' perceptions about the extent to which culturally diverse groups are in contact with one another (multicultural contact); whether diversity is valued and appreciated (multicultural ideology); and whether there are policies and practices that support and accommodate diversity (multicultural policies and practices) in the United States. Results from a path analysis showed that multicultural ideology was negatively associated with AIS and cultural identity conflict. Multicultural contact was positively associated with HIS and bicultural identity consolidation. Multicultural policies and practices had no significant associations. The findings underscore the important role of perceived societal acceptance of multicultural ideology and perceived norms of multicultural contact in managing cultural identities. Furthermore, the study highlights that perceived multiculturalism norms as societal‐level factors combined with individual‐level cultural identity styles can influence the identity outcomes of multicultural individuals. Further research into the role of perceived societal norms for both majority and cultural minority individuals in identity integration is warranted. [ABSTRACT FROM AUTHOR]

Most countries that provide for compulsory treatment for mental illness have a system by which this treatment is subject to independent legal oversight. Many countries use a special type of legal body for this purpose, called a mental health tribunal. Mental health tribunals have been subject to criticism from the points of view of both legal professionals and mental healthcare practitioners. Similar themes have manifested in these criticisms and have been consistent across several decades; legal professionals tend to focus on the tribunals being biased toward the medical opinion, and acting as a 'rubber stamp', whereas healthcare practitioners tend to focus on the adversarial nature of the trial, and the adverse effect that this can have on clients. However, empirical studies of the tribunals have not separated and directly compared these perspectives. This study aimed to explore this dynamic between lawyers' views and healthcare practitioners' views of mental health tribunals. We used thematic analysis to re-analyse data from two previous research studies, one which looked at lawyers' views of the tribunals, and one which looked at healthcare practitioners' views. Our results are divided into three themes: views of the problems with tribunals, professional roles in relationship to the tribunals and professional values demonstrated through these views and roles. We then consider if the 'clash of values' represented by these findings, and found in the literature, may pose an impediment to tribunal reform. Identifying and exploring this barrier is an important step to moving beyond critique to reform. [ABSTRACT FROM AUTHOR]

Objective: Suicide is the second leading cause of death among college-age students in the U.S., with disparities in suicide ideation and attempts among Latinas. The current study aims to examine if depression severity predicts suicide ideation and attempts and to examine if caregiver intergeneration acculturation conflict (IAC) moderates this link. Participants: A sample of 246 Mexican-descent female college students. Methods: Self-reported measures for depression severity, male and female caregiver IAC, and suicide ideation and attempts in the previous 12-months were ascertained. Results: In our sample, 31.1% endorsed suicide ideation and 15.9% suicide attempts. Controlling for age, both male and female caregiver IAC moderated the relationship between depression severity and suicide ideation. A similar moderation pattern emerged for the suicide attempts outcome. Conclusions: Understanding this exacerbating contextual factor can help inform prevention/intervention efforts targeting Mexican-descent college students who are experiencing depressive symptoms by focusing on decreasing IAC with both caregivers. Suicide is the second leading cause of death among emerging adults, defined as 18–29-year-olds,1 in the United States (U.S.) and is responsible for more deaths than any single major medical illness.2 Significant gender and ethnic/racial disparities have been well-documented and highlight that Latina emerging adults experience some of the highest rates of suicide ideation (SI) and suicide attempts (SA) and the greatest increases in SA over time, when compared to non-Latinx White, female emerging adults.3,4 In fact, recent research suggests that Latina college students report a 1.7% prevalence rate of suicide attempts compared to 1.2% among non-Latina White college students and data trends report a nearly double increase in the percent of suicide attempts from 2011 to 2015 (from 0.9% to 1.7%) for Latinas versus a minimal change (from 1.1% to 1.2%) among non-Latina White college students.4 Key research examining this disparity have cited that elevated depressive symptoms, which are also experienced at higher levels among Latinx groups in the U.S.,5 are strongly linked to SI and SA among Latinx college students and emerging adults.6,7 Developmentally, the highest risk period for the onset of SI and SA is during late adolescence or emerging adulthood8 and deaths due to suicide increase as adolescents move into emerging adulthood.2,9 Emerging adulthood is an even riskier developmental period for minoritized college students, like Latinx college students, because this period is marked by identity formation processes that are exacerbated by intercultural interactions on college campuses and cultural expectations at home.10 These data underscore the significance of detecting how unique contextual factors may interact with elevated depressive symptoms, and importantly, how these factors are associated with the increased suicide risk among Latinx college-age youth, as they represent a high-risk developmental and ethnic group. [ABSTRACT FROM AUTHOR]

Background: The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) has long recognized and championed increasing diversity within the surgical workplace. SAGES initiated the Fundamentals of Leadership Development (FLD) Curriculum to address these needs and to provide surgeon leaders with the necessary tools and skills to promote diversity, equity, and inclusion (DEI) in surgical practice. In 2019, the American College of Surgeons issued a request for anti-racism initiatives which lead to the partnering of the two societies. The primary goal of FLD was to create the first surgeon-focused leadership curriculum dedicated to DEI. The rationale/development of this curriculum and its evaluation/feedback methods are detailed in this White Paper. Methods: The FLD curriculum was developed by a multidisciplinary task force that included surgeons, education experts, and diversity consultants. The curriculum development followed the Analysis, Design, Development, Implementation and Evaluation (ADDIE) instructional design model and utilized a problem-based learning approach. Competencies were identified, and specific learning objectives and assessments were developed. The implementation of the curriculum was designed to be completed in short intervals (virtual and in-person). Post-course surveys used the Kirkpatrick's model to evaluate the curriculum and provide valuable feedback. Results: The curriculum consisted of interactive online modules, an online discussion forum, and small group interactive sessions focused in three key areas: (1) increasing pipeline of underrepresented individuals in surgical leadership, (2) healthcare equity, and (3) conflict negotiation. By focusing on positive action items and utilizing a problem-solving approach, the curriculum aimed to provide a framework for surgical leaders to make meaningful changes in their institutions and organizations. Conclusion: The FLD curriculum is a novel leadership curriculum that provided surgeon leaders with the knowledge and tools to improve diversity in three areas: pipeline improvement, healthcare equity, and conflict negotiation. Future directions include using pilot course feedback to enhance curricular effectiveness and delivery. [ABSTRACT FROM AUTHOR]

Objective: To describe and identify associated factors for patient–clinician discordance of disease assessment at biologic or Janus kinase inhibitor (JAKi) initiation and over 12 months following initiation in patients with rheumatoid arthritis (RA) from a US RA registry. Methods: Analyses included CorEvitas RA Registry patients who initiated their first biologic or JAKi on or after February 1, 2015, and had 6‐ and 12‐month follow‐up visits. Positive discordance was defined as patient global assessment (visual analog scale [VAS‐100]) minus physician's global assessment (VAS‐100) equal to 30 points or more. Persistent discordance was defined as positive discordance at all three visits. Mixed‐effects logistic regression was used to determine risk factors for positive discordance at initiation and for persistent discordance. Results: Among 2227 first‐time biologic/JAKi‐initiating patients, 613 had both follow‐up visits available and were included in initiation visit analyses, and of these, 163 had positive discordance at initiation and were included in persistent discordance analyses. About 30% of all patients had positive discordance at any visit, and one third of these (10% total) were persistent at all three visits. Multivariable analyses revealed that worse scores on the Clinical Disease Activity Index, greater patient‐reported pain and fatigue, and greater functional impairment were associated with positive discordance at the time of therapy initiation. Being disabled versus working full‐time and being female were associated with higher odds and having Medicare versus no insurance was associated with lower odds of having persistent positive discordance. Conclusion: Results suggest positive discordance is common among real‐world patients with RA initiating their first biologic or JAKi. The identified risk factors associated with patient–clinician discordance will help clinicians foster a more patient‐centric discussion in treatment decisions. [ABSTRACT FROM AUTHOR]

Objective The purpose of this study was to understand the lesbian, gay, bisexual, transgender, queer, intersex, agender, and other gender and sexually diverse identities (LGBTQIA+) health care experience and associated cultural competence from the physical therapist perspective (physical therapist and physical therapist assistant). Methods An exploratory qualitative approach implementing semi-structured focus groups and private interviews was utilized. To further anonymity, researchers allowed subjects to keep their camera off on Zoom. An interview protocol included questions guided by Campinha-Bacote domains of cultural competence (cultural awareness, skill, knowledge, encounter, and desire) to collect individual experiences, stories, discussions, thoughts, and opinions. Physical therapist clinicians were recruited from the clinical education affiliation lists of Regis University and Thomas Jefferson University. Seventy-one practicing physical therapists from the USA agreed to be part of the study. Results Themes were organized using the Social Ecological Model Framework. Themes are in parentheses following each level of the Social Ecological Model and include intrapersonal level (psychological stress and implicit and explicit biases), interpersonal (acceptance and competency), organizational (experience), community (advocacy), and society and policy (explicit biases and policy). Conclusion Cultural competence in physical therapy is influenced by intrapersonal, interpersonal, organizational, community, and social and policy factors. Themes of psychological stress, limited awareness, decreased acceptance, and competency as well as limited exposure and experience, and a lack of advocacy and broader societal and policy issues prevent adequate LGBTQIA+ cultural competency of physical therapist providers. Further research in the physical therapist profession is needed to elaborate on the student, educator, and patient perspectives and how this information informs the LGBTQIA+ cultural competence of clinicians. Impact This project may have a significant impact on suggestions for the delivery of content for health profession education to best impact health equity goals and save lives. Implementation of this content may have a direct impact on health disparities in LGBTQIA+ populations by reducing stigma and discrimination from health care providers, thus improving quality of health care and decreasing rates of patient mortality for LGBTQIA+ individuals. [ABSTRACT FROM AUTHOR]

The article focuses on the complexities of choosing a surrogate decision maker when faced with conflicting preferences and varying levels of knowledge about the patient. Topics include the ethical considerations of replacing a surrogate, the application of substituted judgment in decision-making, and the role of clinical ethicists in facilitating consensus among decision makers.

The current COVID-19 pandemic exemplifies a crisis that is redefining the meaning of communication for many. Metaphors like the "hero" trope are being used to represent our frontline employees, such as nurses who work directly with COVID-19 patients. However, we know very little about how these tropes influence the identities of these nurses and how it impacts their work. This article draws on social identity theory and key works related to role and identity conflict to look at nurses' perceptions of the hero trope being used to define them during this crisis. The study involved 23 semi-structured interviews with nurses from the United States who were working with COVID-19 patients. Nurses described how, due to COVID-19—especially in light of the hero trope – multiple identities became salient during the pandemic. Many of the identity overlaps were minimized during this time as the trope modified the meaning of how some norms around these different sub-identities were understood. This also highlights the role of communication in shaping and modifying group identity norms during crises, thus suggesting an integration of SIT with the constructivist or even some level of poststructural perspective. As a consequence of the pandemic and the minimized overlaps between the identities, nurses felt more self-doubt or failure, which impacted their overall psychological well-being as well as their efficacy at work. Nurses used communication strategies such as providing reminders, separating myth from reality, and directly approaching their managers, to cope with the identity conflicts. [ABSTRACT FROM AUTHOR]

This study is a linguistic analysis of power relations in selected tweets between the US and Iranian politicians after the killing of the former Iranian leader, Qasem Soleimani. A sample of 33 tweets from politicians of the two countries; the US and Iran, were analyzed using discourse categories from van Dijk's Socio-Cognitive Approach. Simple percentages and Anthony Lawrence's AntConc software were also employed in the analysis of the extracted tweets. Findings revealed the power relations in the tweets during a tense crisis period. Analysis showed similarities in the percentage scores of the US and Iranian politicians' tweets based on van Dijk's categorization processes. The use of pronouns through polarization was also demonstrated in the tweets. [ABSTRACT FROM AUTHOR]

The article focuses on Ray and Cooper's call to prioritize environmental health equity and justice in bioethics, questioning whether the profession has truly adhered to principles of justice and concern for vulnerable populations. It author highlights the historical shift in bioethics towards a narrow clinical focus, particularly in the U.S., and emphasizes the need to reconsider justice in the field, especially in addressing environmental issues.

Background: This study examined the conflicts between different generations working in US emergency departments (ED). We sought to record generational differences involving communication preferences, perceived areas of conflict, work motivations, and attitudes regarding work-life balance. Methods: We developed a survey to assess the physician perspective on generational conflict in the ED. The survey was distributed to members of the American College of Emergency Physicians, a professional organization comprising emergency medicine physicians in the USA. Results: We received 696 completed responses. Men represented 60% of respondents and the largest proportion of respondents were emergency physicians working in community settings (53%); 11% were residents. Generation representation was smallest for Traditionalist (2%) and largest for Gen X (43%). Seventy percent reported observing conflict due to generational communication with the largest frequency being once a week (26%). In the associated open-ended questions, 247 (33%) provided 316 anecdotal descriptions of observed conflict. Responses clustered into seven themes (ordered by frequency): Work Ethic, Treatment Approach, Technology Application, Entitlement, Professionalism, Work Life/Balance, and Communication Style. Comparing Work Ethic responses, 52–70-year-olds reported that younger providers are less interested in "accomplishing anything" while 26–34-year-olds resented that attitude. Respondents completing the open-ended questions regarding preventing and responding to conflict provided some insight into helpful strategies including actions supportive of clear communication and standardized policies and expectations. Only 5% of respondents reported that they had discussed generational communication in department meetings with the odds of a woman reporting conflict being less than males (p =.01). Conclusion: Conflicts in the ED in the USA can be attributed to how an individual views the values of someone from another generation. Understanding the frequency and areas of generational conflict in the ED can help medical leaders find strategies to mitigate negative workplace interactions. [ABSTRACT FROM AUTHOR]

During the 1980s, the increasing institutionalization of the North American gay and lesbian rights movement drastically shifted the goals and methods of 2SLGBTQIA+ activism. Organizations began to focus on achieving access and equality through dominant institutions (such as military service and hate crime legislation) with the goal of achieving "equal citizenship," rather than challenging the foundational inequalities embedded in such institutions. Despite the issues with this kind of approach, contemporary trans resistance is often expected to replicate this framework and make similar demands for trans-specific human rights and legal protections. This article argues that a rights-based approach to trans liberation cannot succeed under the current iteration of biopolitical governance in the United States. Inspired by Henry Giroux's concept of the biopolitics of disposability, the author suggests that contemporary neoliberalism devalues trans lives (especially the lives of racialized trans women and femmes) to such an extent that they are viewed as expendable. Therefore, 2SLGBTQIA+ advocacy that seeks to gain further transgender rights and legal protections from a state that views trans lives as expendable should be abandoned in favour of activist projects that address the most urgent issues facing the most vulnerable trans people, such as employment assistance programs, access to inclusive healthcare, decarceration, and prison abolition projects. [ABSTRACT FROM AUTHOR]

On June 18, 2023, the U.S. Supreme Court in the matter of Amgen, Inc. et al. v. Sanofi, et al. 1 unanimously upheld the 2021 decision of the U.S. Court of Appeals for the Federal Circuit,2 striking down as overbroad Amgen's patent claim to an entire functional genus of monoclonal antibodies. Amgen's patent claims were not limited to antibody structure or antibody amino acid sequences. This is significant because Amgen's patent claims did have amino acid sequences, but they were directed to the epitope. [ABSTRACT FROM AUTHOR]

During the past 50 years, medical and behavioral scientists have made great progress in understanding the variables which influence the development of sexual orientation, identity, and consequent behavior. In most instances, homosexuality is influenced by hormonal, genetic, and immunologic variables during fetal development, and the effects cannot usually be altered without consequence. The recent struggle within The United Methodist Church in the USA reflects the difficulty that society in general has with accepting homosexuality as part of the spectrum of sexuality. Hopefully, understanding the factors influencing sexual orientation will aid in reducing prejudice and eventually bring an end to the pain endured by the LGBTQ community, and the conflict within The United Methodist Church, a prototype of the struggle. [ABSTRACT FROM AUTHOR]

The article focuses on navigating disagreements among surrogate decision makers in healthcare ethics. Topics include ethical principles guiding surrogate decisions such as respecting patient autonomy through substituted judgment and the variability in state laws regarding surrogate decision-making hierarchies.

Introduction: Suicide is a leading cause of death in children; youth who identify as LGBTQ+ are at an exponentially higher risk of suicide. The purpose of this study was to explore the lived experiences of youth who identify as LGBTQ+ and sought emergency care for suicidality as adolescents. Methods: Hermeneutics phenomenology is the research method used in this study. Youth who identify as LGBTQ+ and sought emergency treatment for suicidality when they were adolescents were recruited; fifteen youth enrolled. Individuals ranged in age from 20 to 25 years. Participants described their gender identity as male, female, non‐binary, transgender female, and their sexual orientation as: female, demisexual, bisexual, gay, homosexual, lesbian, queer, asexual, and transgender. Results: This study establishes that youth who identify as LGBTQ+ seeking emergency care for suicidality value: coping and control, acceptance from others and self, communicating with me about me, and moving beyond danger and distress. Lack of psychological safety—from the emic perspective—emerged as a critical finding. Conclusion: This research has strong implications for public health, policy, and research. Future research must seek to understand ways in which psychological safety is assessed in healthcare if we are to more deeply understand and effectively address the impact on health equity. [ABSTRACT FROM AUTHOR]

This study explores the unique experiences of the emotional processing of the widowhood of individuals of the Chinese seniors, and immigrant background in the United States. By interviewing eight Chinese immigrant widows living in Phoenix, the United States, this study focuses on the comparison of social relations and lifestyles before and after their spousal loss, as well as the unique forces of their Chinese backgrounds and the transnational remarriages in their bereavement process, and then widow status. The narrative accounts of the participants therein illustrate that transnational marriage and blended families generate a series of practical challenges, including unexpected severed friendships and inheritance disputes between stepmother and stepchildren. The consequences are reflected in the increase of self-loathing and low self-esteem, the refusal to remarry, the rising anger at the betrayal of friends, as well as the rapid formation of a high level of independence and self-determination in such circumstances. These findings increase knowledge of widowhood of Chinese women with immigrant background, therein enrich ethno-cultural diversity in the widowhood studies.This study concludes with the implications of providing bilingual legal aid and counseling to Chinese-origin, US-based, and widows. [ABSTRACT FROM AUTHOR]

False allegation of violence and abuse is an under-recognized problem in custody disputes and divorce cases. However, only a handful of studies have investigated false allegations of domestic violence as a phenomenon in itself. Thus, the aim of the present study was to explore the experiences of individuals (male and female), who were recognized as falsely accused of domestic violence. An interpretive phenomenological analysis approach was utilized to analyze interviews conducted with 19 false allegation victims. Participants' interviews revealed three superordinate themes: (1) "I was the victim in this relationship:" False allegation as a form of lifelong intimate partner violence; (2) "I felt everything crashing down on me:" False allegation as a traumatic event; (3) "This battle has brought me to my knees:" A series of losses following false allegations. The findings may provide some qualitative insights into the experience of false allegation and its possible connection to coercive control in the context of partners' conflictual relationships. It is important for professionals to acknowledge false allegations as abusive tactics used within domestic violence situations as they cause considerable pain to the individuals involved. [ABSTRACT FROM AUTHOR]

Background: Conflict between clinicians is prevalent within intensive care units (ICUs) and may hinder optimal delivery of care. However, little is known about the sources of interpersonal conflict and how it manifests within the context of palliative and end-of-life care delivery in ICUs. Objective: To characterize interpersonal conflict in the delivery of palliative care within ICUs. Design: Secondary thematic analysis using a deductive–inductive approach. We analyzed existing qualitative data that conducted semistructured interviews to examine factors associated with variable adoption of specialty palliative care in ICUs. Settings/Subjects: In the parent study, 36 participants were recruited from two urban academic medical centers in the United States, including ICU attendings (n = 17), ICU nurses (n = 11), ICU social workers (n = 1), and palliative care providers (n = 7). Measurements: Coders applied an existing framework of interpersonal conflict to guide initial coding and analysis, combined with a flexible inductive approach allowing new codes to emerge. Results: We characterized three properties of interpersonal conflict: disagreement, interference, and negative emotion. In the context of delivering palliative and end-of-life care for critically ill patients, "disagreement" centered around whether patients were appropriate for palliative care, which care plans should be prioritized, and how care should be delivered. "Interference" involved preventing palliative care consultation or goals-of-care discussions and hindering patient care. "Negative emotion" included occurrences of silencing or scolding, rudeness, anger, regret, ethical conflict, and grief. Conclusions: Our findings provide an in-depth understanding of interpersonal conflict within palliative and end-of-life care for critically ill patients. Further study is needed to understand how to prevent and resolve such conflicts. [ABSTRACT FROM AUTHOR]

Using a questionnaire survey, this study examined Latinx mothers' (n = 72) perception of Latinx grandparents' involvement in children's physical activity. Data were collected about a specific child (i.e., focal child) and a specific grandparent who spent the most time with the focal child (i.e., focal grandparent). Results showed that mothers perceived a substantive level of grandparental support for child's physical activity and a small-to-moderate level of disagreement with grandparent in child's physical activity. Mother-grandparent disagreement negatively affected grandparent's support, which in turn positively affected child's physical activity. Socio-demographic and household-related correlates of mother-grandparent disagreement and grandparent's support were also examined. [ABSTRACT FROM AUTHOR]

Current research supports that both psychological/physical maltreatment by parents and parent-child relationship quality strongly correlate with children's psychopathology. Less research has examined the interaction effects among these variables, especially in emerging adults. The current study analyzed the association between psychological/physical maltreatment experienced from one parent and antisocial behaviors displayed by emerging adults, as well as the moderating effect of the other parent's parent-child relationship quality. This sample included 1,364 emerging adults (953 females, 411 males) who reported on past year psychological and physical maltreatment and parent-child relationship quality. Results indicated that, when considered together, parent-child relationship quality was a stronger predictor of emerging antisocial problems than maltreatment, with the exception of the father-son dyad. Additionally, overall findings suggested that having a high-quality relationship with one caregiver was associated with lower antisocial problems in the context of high maltreatment from the other caregiver. Nevertheless, there were deviations from this norm. Unexpectedly, the lowest antisocial problems in females were associated with higher levels of paternal physical maltreatment combined with higher levels of maternal parent-child relationship quality. Moreover, the combination of low paternal psychological maltreatment and low maternal relationship quality was associated with particularly high antisocial problems in males. It is important to note the findings in the context of this sample of college students, who could be considered an advantaged group relative to some others. Since our sample might not represent our entire population of interest, which is emerging adults, it is important for future studies to examine these relationships across more diverse emerging adults. Practical implications are discussed. [ABSTRACT FROM AUTHOR]

We explored the challenges and lived experiences of intimate partner violence (IPV) survivors during the COVID-19 pandemic by interviewing 53 U.S.-based IPV advocates between June and November 2020. Advocates described how the COVID-19 pandemic limited survivors' abilities to meet their basic needs. The pandemic was also described as being used by abusive partners to perpetrate control and has created unique safety and harm reduction challenges. IPV survivors experienced compounding challenges due to structural inequities. IPV must be considered by local, state, and federal governments when developing disaster planning policies and practices, including in the context of pandemics. [ABSTRACT FROM AUTHOR]

This study investigated the factors that underlie the relationship between work–family conflict (WFC) and women engineers' intention to leave the occupation. The study draws from three theories: Conservation of Resources (COR) theory, turnover theory, and Rhodes and Doering's (1983) integrated model of career change. We proposed that both work interference with family (WIF) and family interference with work (FIW) influence women's intention to leave an engineering occupation by decreasing their commitment to the occupation. Using insights from the above theories and models, we further examined how perceptions of support from the organization changed the relationship between commitment to the occupation and intention to leave the occupation, as well as how conflict between work and family was related to intention to leave the occupation. We tested our predictions using time‐lagged data from a sample of 245 women engineers. The results revealed that occupational commitment mediated and explained the positive relationship between FIW and occupational turnover intentions but not the relationship between WIF and occupational turnover intentions. In addition, perceptions of organizational support influenced the relationship between occupational commitment and occupational turnover intentions and also the indirect relationship between FIW and occupational turnover intentions. Theoretical and practical implications of the findings as well as future research directions are discussed. [ABSTRACT FROM AUTHOR]

This paper reports findings from a qualitative study on the triggers of hospital social workers' moral distress at a large southern U.S. health system. Moral distress occurs when ethical conflict cannot be resolved in a way that aligns with an individual's personal and professional values and ethics. Participants indicated that moral distress derives from both individual interactions and the culture and climate of health systems. For example, participants expressed how sources of moral distress derived from client-centered decisions, such as end-of-life care and patient autonomy; interpersonal dynamics, including team or supervisory conflict; structural issues, such as insurance barriers or internal hospital policies; and organizational values, such as perceptions of institutional support and validation. Implications of this research suggest that health systems need to foster positive ethical environments that nurture clinicians' health and mental health through programs that aim to increase moral resilience, promote empowerment, and foster wellness. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has disrupted the lives of many high school and college students, and recent studies indicate increased emotional distress in this age group. We examined associations among 10 pandemic-related concerns, 21 affects, and three self-regulatory skills using cross-sectional online survey data from high school and college students in two regions of the United States (Study 1: N = 392 and Study 2: N = 1,200). Network models of regularized partial correlation networks revealed both equifinal and multifinal pathways between specific COVID-19 concerns and positive and negative affects. In both studies, concern about conflict with parents was the pandemic-related concern most strongly connected to negative affects, mindfulness was most strongly connected to pandemic-related concerns and negative affects, and self-compassion was most strongly connected to positive affects. These findings provide greater insight into risk and resilience factors associated with students’ emotional well-being during the first year of the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Social comparison processes between siblings play an important role in the ways siblings influence one another at younger ages, but to our knowledge, no studies have examined social comparison processes between siblings in mid- to later life. The current study examined (1) factors associated with the propensity for social comparisons with a sibling and (2) how social comparison is linked to well-being and sibling relationship quality. Data came from 491 adults from across the United States (M age = 58.96, SD = 6.25; 68% female). Results indicated that adults who are the same sex as their sibling are more likely to engage in social comparison with their sibling. Additionally, an inclination for social comparison with a sibling was linked to more depressive symptoms, more sibling conflict, and greater sibling closeness. Overall, comparison with a sibling in adulthood may be linked to both positive and negative outcomes. [ABSTRACT FROM AUTHOR]

This study uses a risk and resilience framework to examine short-term self-reported changes in relationship conflict early in the COVID-19 pandemic (March and April 2020). Longitudinal data from U.S. adults in a romantic relationship (N = 291) were collected via three waves of an online survey. Participants self-reported anxiety, depression, increased alcohol use, and dyadic coping since the pandemic. Relationship conflict variables included whether the participant reported that they and their partner "had disagreements related to the Coronavirus," "had more disagreements than usual," "had more verbal fights than usual," and "had more physical fights than usual" in the past two weeks. Analyses controlled for sociodemographic characteristics as well as days spent in lockdown and employment change due to COVID-19. Results indicated that couples' disagreement and verbal fighting scores increased from Time 1 to Time 2, but disagreements related to COVID-19 and physical fighting did not. Couples with higher levels of dyadic coping reported fewer fights and disagreements on average. However, dyadic coping did not buffer participants from increases in relationship conflict. Increased alcohol use since the pandemic was positively associated with disagreements related to COVID-19, disagreement scores, and verbal fighting scores. More days spent in lockdown was associated with increases in disagreements related to COVID-19. The conditions created by COVID-19 may contribute to worsening relationship conflict, even among couples who start with high levels of dyadic coping. Depression and alcohol use may contribute to poorer relationship quality during the pandemic. There is need for enhanced intervention and mental health supports to mitigate the potential effects of the pandemic on couples' relationship functioning. [ABSTRACT FROM AUTHOR]

Diagnosing the causes of clients' career indecision is among the first steps in career counseling. The present study applied latent profile analysis to identify career indecision types using the 10 difficulty scale scores of the Career Decision-Making Difficulties Questionnaire (Gati et al., 1996). In two random U.S. samples (Ntotal = 8,918; age range = 14--50), five profiles of career indecision were identified and replicated: (1) unmotivated (6%), (2) generally indecisive (31%), (3) unrealistic (12%), (4) uninformed (39%), and (5) conflicted (12%). Age and gender negligibly predicted career indecision type, thereby supporting the stability of the five-profile typology. Nonetheless, the female gender was associated with a greater likelihood of being classified as indecisive as opposed to unmotivated (OR = 2.13). Furthermore, the five types differed in career decision status (η² = .28) and perceived career decisional distress (η² = .29). Uninformed and conflicted individuals reported multiple career decision-making difficulties and were still considering many career alternatives, whereas the three remaining types had one salient difficulty and had already identified a few (or even one) preferred alternative(s). Typological classification of individuals based on their salient causes of career indecision facilitates intervention planning as well as prescreening clients for individual counseling or group interventions. [ABSTRACT FROM AUTHOR]

The Family Stress Model (FSM) posits that environmental stressors disrupt key parenting and family processes via increases in parents' psychological distress. Few studies, however, have examined whether Latinx parents' perceptions of discrimination, a salient environmental stressor for Latinx populations, disrupt parent–child relationships. It is particularly important to examine acceptance and conflict in the parent–child relationship during children's adolescence as this is a time when the parent–child relationship can be particularly vulnerable. The current study examined whether parents' perceptions of discrimination predicted lower acceptance and higher conflict in the parent–adolescent relationship, via elevated parental depressive symptoms. Data were from a longitudinal study of 749 U.S. Mexican families with adolescents (48.9% female; mean age = 10.42, SD = 0.55 at Wave 1) and were examined using path analyses. Mother's discrimination experiences predicted higher levels of mother-reported mother–adolescent conflict through higher levels of maternal depressive symptoms. Additionally, maternal discrimination directly predicted declines in mother-reported acceptance for boys, but not for girls. Paternal discrimination experiences were positively associated with paternal depressive symptoms, but paternal depressive symptoms were not associated with father–adolescent relationship processes. The current study underscored discrimination as a salient stressor for U.S. Mexican mothers' and fathers' psychological wellbeing, and, for mothers, these experiences may influence their relationships with their adolescents. [ABSTRACT FROM AUTHOR]

In the United States, growing attention to the cost of care, the social determinants of health, prevention, and population health, signals a refocusing of efforts on value-based care. Just as Accountable Care Organizations and alternative payment models exemplify this shift in attention, so does the increasing integration of Community Health Workers (CHWs) into the US health care system. CHWs are often referred to as "bridge figures," helping clients to navigate what are oftentimes complicated pathways to access a variety of needed services. The integration of CHWs into interprofessional care teams is a process that takes time, and can lead to conflict as traditional care models are disrupted. Through focus groups with CHWs in rural and urban areas of four states, this work identifies and describes three early stages in the evolving interprofessional relationships between CHWs and other care providers. These stages are characterized by: (1) a lack of knowledge and understanding of CHW roles, (2) conflict and competition, and (3) engagement and integration of CHWs into patient care teams. A better understanding of the evolving process of CHW integration is critical to facilitate education and training that will more quickly encourage the development and efficacy of modern models of interprofessional care that include CHWs. [ABSTRACT FROM AUTHOR]

On March 11, 2020, COVID-19 was declared a pandemic by the World Health Organization. The social isolation and economic stress resulting from pandemic have the potential to exacerbate child abuse and neglect. This study examines the association of parents' perceived social isolation and recent employment loss to risk for child maltreatment (neglect, verbal aggression, and physical punishment) in the early weeks of the pandemic. Participants (N = 283) were adults living in the U.S. who were parents of at least one child 0–12 years of age. Participants completed an online survey approximately 2 weeks after the World Health Organization declared that COVID-19 was a pandemic. The survey asked about recent changes (i.e., in the past 2 weeks) to employment status, parenting behaviors, use of discipline, use of spanking, and depressive symptoms. Nearly 20% of parents had hit or spanked their child in the past two weeks alone. Parents' perceived social isolation and recent employment loss were associated with self-report of physical and emotional neglect and verbal aggression against the child, even after controlling for parental depressive symptoms, income, and sociodemographic factors. Parents' perceived social isolation was associated with parental report of changes in discipline, specifically, using discipline and spanking more often in the past 2 weeks. Associations were robust to analyses that included two variables that assessed days spent social distancing and days spent in "lockdown." Study results point to the need for mental health supports to parents and children to ameliorate the strain created by COVID-19. [ABSTRACT FROM AUTHOR]

Although parents are the default legal surrogate decision-makers for minor children in the U.S., shared decision making in a pluralistic society is often much more complicated, involving not just parents and pediatricians, but also grandparents, other relatives, and even community or religious elders. Parents may not only choose to involve others in their children's healthcare decisions but choose to defer to another; such deference does not imply agreement with the decision being made and adds complexity when disagreements arise between surrogate decision-makers for minor children and their physicians. I argue that clinicians and ethicists have a duty to consider voices marginalized by hierarchical structures, including but not limited to gender-based inequalities. This approach involves negotiating potential conflicts: between respecting differences of culture and religion, on one hand, and assuring that the wishes of those who are most invested in children's lives are considered, on the other. [ABSTRACT FROM AUTHOR]

This study examined predictors to mask mandate support and racial justice protest participation across Asian (n = 103), Black (n = 102), white (n = 102) New York City residents, using binary logistic regressions. Participants with positive feelings about the racial justice movement were more likely to participate in the protests. White and Asian respondents were more likely to support the mask mandates over Black respondents. Asian respondents were less likely to participate in public protests over white respondents. Our findings offer a model for social workers to understand how race, political participation and COVID-19 intersect to create racially just responses to health and justice matters. [ABSTRACT FROM AUTHOR]

This study investigated the effects of supervisee characteristics (rejection attachment), the supervisory relationship (supervisory working alliance, role conflict), and Asian cultural values on supervisee nondisclosure (clinically related and supervision related nondisclosures) for South Korean and U.S. American supervisees. Participants were 474 predominantly female supervisees in counseling and clinical psychology programs (227 South Korean, 247 U.S. American). Three major findings emerged: (a) the four predictors collectively predicted both types of supervisee nondisclosure jointly in both countries, (b) the supervisory working alliance predicted the two types of supervisee nondisclosure jointly in both countries, and (c) post hoc tests suggested that the supervisory working alliance mediated the relations of role conflict and rejection attachment with supervisee nondisclosure in both countries, and the relation of Asian cultural values with supervisee nondisclosure for South Korean supervisees. Implications for theory, research, and practice are discussed. [ABSTRACT FROM AUTHOR]

Background Despite the availability of safe and efficacious coronavirus disease 2019 vaccines, a significant proportion of the American public remains unvaccinated and does not appear to be immediately interested in receiving the vaccine. Methods In this study, we analyzed data from the US Census Bureau's Household Pulse Survey, a biweekly cross-sectional survey of US households. We estimated the prevalence of vaccine hesitancy across states and nationally and assessed the predictors of vaccine hesitancy and vaccine rejection. In addition, we examined the underlying reasons for vaccine hesitancy, grouped into thematic categories. Results A total of 459 235 participants were surveyed from 6 January to 29 March 2021. While vaccine uptake increased from 7.7% to 47%, vaccine hesitancy rates remained relatively fixed: overall, 10.2% reported that they would probably not get a vaccine and 8.2% that they would definitely not get a vaccine. Income, education, and state political leaning strongly predicted vaccine hesitancy. However, while both female sex and black race were factors predicting hesitancy, among those who were hesitant, these same characteristics predicted vaccine reluctance rather than rejection. Those who expressed reluctance invoked mostly "deliberative" reasons, while those who rejected the vaccine were also likely to invoke reasons of "dissent" or "distrust." Conclusions Vaccine hesitancy comprises a sizable proportion of the population and is large enough to threaten achieving herd immunity. Distinct subgroups of hesitancy have distinctive sociodemographic associations as well as cognitive and affective predilections. Segmented public health solutions are needed to target interventions and optimize vaccine uptake. [ABSTRACT FROM AUTHOR]

The impact of social support on suicide is understudied among youth experiencing homelessness (YEH). This is problematic because assumptions about the protectiveness of relationships may not generalize to conflictive YEH environments. This study, which included 1047 YEH, used path modeling with a logistic regression estimator to examine associations between social support from family, home-based friends, and street-based friends and past-year suicide attempt. Social support from home-based friends but not family or street-based friends decreased suicide attempt risk. Moreover, social support from home-based friends moderated the association between depression and attempt risk. Targeted programming strengthening home-based-friend relationships represents a valuable endeavor. [ABSTRACT FROM AUTHOR]

This study uses open source information to examine school shootings in the United States for the 1990–2016 period. We innovatively created a national-level database to address the gaps in existing research and identified 652 school shootings. These shootings included 473 intentional shootings (encompassing 354 with known offenders and 119 with unknown perpetrators), 102 suicide only shootings, 73 accidental discharges and 4 legally justified shootings. Most school shootings were committed outside of the school building (e.g., school yard), by non-students, during non-school hours and were sometimes motivated by non-school issues such as gang disputes. Almost 56% of the intentional shootings resulted in no deaths and mass homicide shootings were outliers. No clear time trend emerged. Importantly, proportionally more of the non-juvenile offenders committed fatal shootings. While the vast majority of attacks targeted high schools, those against elementary schools were more deadly. We outline how these findings could aid policymakers, and highlight issues that future research could address with these data. We also describe our open source collection procedures, the amount and type of information uncovered, and how we assessed their quality. We aim to set a standard for more transparent open source data collection processes and enhance the data's rigor to provide important context to the larger policy discussions about school shootings. [ABSTRACT FROM AUTHOR]

The most recent national anthem protests, which were initiated by Colin Kaepernick in 2016, have elicited a variety of reactions from people and deeply split public opinion. Previous research regarding the perceptions of these protests has identified race as a significant factor. In this study, I take a fresh look at the role of race by examining attitudes toward the national anthem protests among Latinx American young adults. Additionally, the study also examines the impact of perceptions of police, perceptions of injustice, and political engagement on Latinx perceptions of the national anthem protests. The results of the study surprisingly and interestingly show that race did not play a significant role in shaping attitudes toward the protests. However, perceptions of police, perceptions of injustice, and political engagement were all significantly related to attitudes toward various forms of national anthem protests. The meaning, the significance, and the implications of these results are discussed. [ABSTRACT FROM AUTHOR]

Romantic coupling in the United States is changing (e.g., communication patterns). Research investigating couple conflict topics has not updated with current trends. A large, representative sample (n = 1,013) selected frequent couples conflict topics and reported relationship satisfaction and conflict behaviors. Results suggested communications was the most frequently reported conflict topic for all couples and parenting was the most frequently reported conflict topic for parents. Other commonly reported topics included personal/partner habits, household chores, finances, decision-making, quality time, sex, screen time, role expectations, and time management. Finances, parenting, and sex were negatively associated with relationship satisfaction, whereas household chores and time management were positively associated with relationship satisfaction. Communication, finances, parenting, and sex were associated with an increase in dysfunctional conflict behaviors, whereas time management was associated with a decrease in dysfunctional conflict behaviors. Understanding how conflict sources affect relationships may help couples navigate conflict to preserve the relationship. [ABSTRACT FROM AUTHOR]

Background: This study evaluated two risk pathways that may account for increases in child internalizing and externalizing problems during the COVID‐19 pandemic: one pathway operating through pre‐existing family vulnerability and a second pathway operating through disruption in family functioning occurring in response to the pandemic. We assessed family disruption and family functioning with measures of key family‐level and parenting dimensions, including family cohesion, conflict and routines, and parents' harsh discipline, lax discipline and warmth. In all models, pre‐pandemic parent emotional distress, financial strain and child maladjustment were included as covariates. Methods: The sample included 204 families, comprised of parents who had children (MAge = 4.17; 45.1% girls). Parents (MAge = 27.43) completed the first survey prior to COVID‐19 onset in the United States, a second survey after COVID‐19 onset in May 2020 and a third survey two weeks later. Results: Analyses were conducted in a model‐building fashion, first computing structural equation models for each family and parenting dimension separately, then advancing significant dimensions into one integrated model for the family‐level factors and a second model for parenting quality factors. Results provided more support for the family disruption hypothesis across all tests. In the family‐level domain, decreases in family cohesion and increases in family conflict each uniquely predicted subsequent child maladjustment. In the parenting domain, increases in harsh discipline and lax discipline each uniquely predicted subsequent child maladjustment. Family routines and parental warmth were not associated with child adjustment. However, parents' emotional distress prior to the pandemic exhibited a robust association with children's internalizing problems. Conclusions: These findings indicate that efforts to support families in adapting to unique conditions of the pandemic will yield the greatest effect for child adjustment. Specifically, interventions should include efforts to help families maintain cohesion and manage conflict, and help parents minimize increases in harsh and lax discipline. [ABSTRACT FROM AUTHOR]

While research suggests that gender role conflict influences the mental health of men of color, few studies have examined how racial discrimination may contribute to men of color's gender role conflict and subsequently their mental health, including their depressive symptomatology. The racist-gender stress model highlights how racial discrimination may heighten men of color's gender role conflict which then portends negative mental health. With a sample of 206 U.S. college-attending men of color, the present study therefore longitudinally examined the direct and indirect effect of racial discrimination on depressive symptomatology through two forms of gender role conflict, Work Conflict and Success, Power, and Competition. Participants completed surveys containing study questionnaires 6 months apart. Controlling for baseline depression, racial discrimination was both directly associated with Wave 2 (6 months later) depression and indirectly associated through Work Conflict. Racial discrimination was not indirectly associated with depression through Success, Power, and Competition. These findings underscore the necessity of considering how racial discrimination affects men of color's gender-related stress which is then associated with depressive symptoms. Results also emphasize the importance of intervening to prevent racial discrimination from occurring in the first place to bolster men of color's psychological well-being. [ABSTRACT FROM AUTHOR]

To a great extent, the effectiveness of a government may be traced to its constituting documents which serve as a guide or map for how it is supposed to function. From a systems perspective, we may expect a more systemic Constitution to inform the operation of a government that is more systemic and so more effective. This paper uses Integrative Propositional Analysis (IPA) to conduct a preliminary evaluation of the systemic structure of the US Constitution. The analysis finds that the US Constitution has a vanishingly low level of structure. This previously unrecognized lack of structure provides a new explanation for why the nation is increasingly misgoverned (and/or more difficult to govern) and why divisions are deepening between partisan groups, leading to argument and conflict. A path forward is suggested to develop a more systemic Constitution and more effective governance; one supporting a more just, prosperous, and sustainable society. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study is to describe job satisfaction and multigenerational nursing characteristics between nurses in the United States, Italy and Finland. Background: Job satisfaction and work characteristics may be viewed differently among nurses of different generations and countries. Methods: Data were collected on the Kuopio University Hospital Job Satisfaction Scale and Multidimensional Nursing Generations Questionnaire. A total of 1,433 usable surveys were returned and analysed using multivariate analysis of variance. Results: Nurses in the United States were most satisfied in all subareas of job satisfaction. Across all generations and countries, Leadership scores were most consistent. Results did not show any generational similarities on job satisfaction or generational work characteristics that held constant across all countries. Scores on dimensions indicating intergenerational conflict were highest in the United States and lowest in Finland. Measures indicating good intergenerational relationships and teamwork were highest in Finland and lowest in the United States. Conclusions: Country impacted job satisfaction and multigenerational characteristics more than generational cohort. Implications for Nursing Management: Nurse managers and leaders leading multigenerational teams occupy a pivotal role in multigenerational teamwork and attitudes toward change. [ABSTRACT FROM AUTHOR]

As the field of psychology continues to make efforts to diversify the field, training programs must adapt to include the needs of diverse students. Universities in the United States mirror middle-class norms and values, which implies that students are expected to separate from familial roles and focus on their personal growth. This conflicts with core values and intentions of students from collectivist cultures. Although psychology trainees are obligated to adhere to professional ethical standards, a growing number of psychology trainees from collectivistic cultures need support to manage role conflict within potentially ambiguous standards regarding how to care for family and community members. This need is further complicated when training programs consider the lack of equitable access to mental health care resources in communities where their psychology trainees come from. In this paper, we engage in ethical decision making to address two scenarios representing role conflict between training program expectations and collectivist community and familial obligations. Through this exercise we develop and propose a Decision-Making Model for Addressing Role Conflict for Psychology Trainees. This conceptual model details a novel framework to assist psychology trainees when addressing the mental health of family and community while also providing guidance to help graduate training programs proactively equip their students with the skills and ethical framework they need to balance role conflicts such as when family and community members desire and need mental health support. [ABSTRACT FROM AUTHOR]

Teachers often find themselves in the midst of developing their own ideologies while facing authoritative demands on classroom instruction. Internally persuasive discourses shaping these ideologies come from education theories, methods instruction, professional workshops, and teachers' own research. This narrative inquiry follows four graduate students and the teacher researcher in a graduate education course as they discover ways to improve their classroom practices while finding authoritative voices for themselves. Narrated by the teacher researcher, participants' stories illustrate authoritative discourses in teaching contexts, internally persuasive discourses framing ideologies about teaching, and the reflective inquiry interanimating the two. Using reflective inquiry to mediate authoritative and internally persuasive discourses, participants navigated tensions caused by these two conflicting discourses while experiencing ideological becoming. Findings indicate that multimodal/multigenre inquiry projects provided access, legitimacy, competence, and values. Further, next steps suggest the importance of using reflective inquiry to mitigate contentious discourses in education. [ABSTRACT FROM AUTHOR]